Magnetic resonance imaging (MRI) brain scans of children could reveal changes associated with multiple sclerosis (MS) before any symptoms are developed, according to a study by scientists at Yale University School of Medicine. The findings suggest that brain and spinal cord scans can identify children at high risk for developing MS.
Children who had signs of antibodies in their spinal fluid or lesions in the spinal cord were more likely to develop MS symptoms, researchers found.
The study participants had what researchers call radiologically isolated syndrome (RIS), which are MRI lesions that indicate a loss of myelin. RIS has been studied in adults, and researchers know that about one-third of adults with these lesions eventually develop MS symptoms. But until now, no one had studied RIS in children.
“For the first time we have proposed a definition of RIS in children,” Naila Makhani, MD, assistant professor of pediatrics and neurology at Yale and lead author of the study, said in a press release.
Published in the journal Neurology: Neuroimmunology & Neuroinflammation, the study followed 38 children who had an MRI scan in which researchers found demyelinating lesions. The children underwent the scan for other reasons, including headaches, depression, seizures, and concussions. Headaches were the cause of the scans in more than half of the cases.
According to the report, “Radiologically isolated syndrome in children — Clinical and radiologic outcomes,” more than two-thirds of the children were girls. Participants were followed for an average of 4.8 years. Among them, 29 had spinal cord MRI scans and 23 also had a spinal tap done to test the spinal fluid.
Fifty-seven percent had signs of antibodies — so-called oligoclonal bands — and 17 percent had spinal cord lesions.
In the entire group, 42 percent developed MS symptoms within a median time of two years. While the group was small, the data indicate that children with RIS develop MS symptoms sooner than adults, who typically have a five-year delay between MRI lesions and first symptoms.
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